ABSTRACT 918

Abstract

Background and aims: Massive hemorrhage (MH) is a clinical situation that necessitates the ability to work in interdisciplinary team. Aims: To evaluate the application of a MH protocol and the ability to work in interdisciplinary teams using simulation and targeted training. Methods: This prospective observational study was held at the simulation lab of a tertiary health care facility. Participants were nurses, respiratory therapists, orderlies, anesthetists, obstetricians, pediatric emergency physicians, intensivists and hematologists. Teams were submitted to high fidelity simulated MH scenarios. All sessions were videotaped. Targeted training consisted of a debriefing session and a presentation reviewing the protocol as well as teamwork skills. Documents were given during the first session to prepare for the post session two weeks later. Confidence questionnaires were filled out during both sessions. Four blinded independent trained raters reviewed the videos and assessment of performance was done using two checklists. Performances scores were compared using an ANOVA test; confidence questionnaires were compared using a Mann Whitney test. IRB approval was obtained for this study. Results: Sixty-two healthcare professionals involved in 8 interdisciplinary teams participated in the study. Following training, scores for the application of the MH protocol improved by 24% (10-39), p=.002. Scores for the ability to work in teams improved by 17% (6-28), p=0.006. Confidence levels in the ability to apply the MH protocol and work in teams improved by 13% (11-16), p<0.0001. Conclusions: Targeted training using simulation improved participant ability to apply the MH protocol, improved interdisciplinary teamwork skills and confidence levels among participants from all disciplines.